What the anti-vaccine movement means for insurers

Conversely, nor have suits filed by families claiming that forced participation in vaccination programs have caused harm to their children. In 1986, the U.S. government passed the National Childhood Vaccine Injury Act (NCVIA). That established the Vaccine Injury Compensation Program (VICP), a trust fund set up in an attempt to staunch the multi-million-dollar verdicts waged against vaccine manufacturers and provide a compensation system for those whose children were found to have suffered injuries due to vaccinations. Claimants must show that a covered condition, as outlined by the Health Resources and Services Administration (HRSA), occurred within the stated time period considered by HRSA to indicate a correlation with vaccination. Claimants meeting the criteria are deemed eligible for federal compensation.

While that's helped to some degree, thimerosal, a preservative used in many vaccines, has now entered the legal landscape as a potential link to autism. Since 2001, there have been 5,000 thimerosal-related claims filed against VICP and attempting to link thimerosal with autism. These cases have not been successful to date, and Jason McDonald, spokesperson for the Centers for Disease Control in Atlanta, believes it's because autism claims rest on a shaky foundation: the now-retracted Wakefield report linking autism to vaccinations.

McDonald says despite the reluctance of a growing number of parents to immunize their children, there's been little statistical change in the number of children being immunized. "We have had over 90 percent vaccination rates in the United States since the mid-90s," says McDonald. "Looking at the national picture alone, it would appear the movement has not worked."

McDonald cautions, however, that the impact of anti-immunization pushes may be hard-felt at the community level. "If enough children do not get immunized, it can break down community immunity and pose a danger to kids who are either too young to get vaccinated or unable to get vaccinated against the diseases – children being treated for cancer, for example – as well as those children for whom the vaccine did not provide immunity," McDonald says.

For Anne Myers, the issue is both a professional and personal dilemma. Myers, partner with Kaufman Dolowich & Voluck, Blue Bell, PA, concentrates her practice on insurance coverage. However, she sees all too well the human side to the anti-immunization movement. Myers says five children in her family have autism. "This is something my family thinks about a great deal."

Still, despite one family member spending $15,000 annually to provide treatment for an autistic child, Myers isn't ready to say definitively that vaccinations are the culprit. "No one is willing to say vaccines cause autism, but something is going on," she says. "Children have to be treated for illness."

What insurers need to know

Insurers are notably silent on the subject. Calls to several carriers netted no response. Chung says that's not surprising. Chung, who handles Edwards Wildman Palmer's insurance and reinsurance business, believes insurers are not yet willing to subrogate costs associated with these diseases, but insurers are concerned about customers becoming ill due to non-vaccinated people. "It's going to be hard to imagine a situation where these issues are elevated to lawsuits," he says. What's really required is a scientifically reliable causal relationship" which he says is currently difficult to prove.

However, Chung thinks legal action could hit the radar of insurers if more children go without immunization. He believes any future litigation will boil down to the preventable aspect and the seriousness of the illness or injury. Because policies are written on a group basis, Chung says the impact to insurers may not be felt any time soon by the few who aren't vaccinating their children. Could insurers charge higher rates to people who refuse to immunize? "Yes," Chung says. "But practically, it could be difficult to enforce."

Instead, insurers should be educating the public, he suggests. "They'll need to push back against any movement, the anti-vaccine movement, to use the scientific evidence available to date to counter-balance whatever the movement is doing to affect the decision to vaccinate or not vaccinate," Chung says.

As far as vaccine safety goes, Myers says insurance companies are absolutely golden because of VICP. That cuts them out of the loop from a liability standpoint, she adds. They're not entirely out of the woods when it comes to costs, though. "They will experience increased costs in health care because of the children that do cause a mini epidemic," Myers says.

What is clear, says Myers, is that people on either side of the issue are passionate in their beliefs. That in itself could be why insurers are avoiding commentary. "It's a hotly debated issue. There are people who say if you're not vaccinating your child exactly on the schedule that the AMA recommends, then you are a bad citizen and a goddamn fool. Then there are others who say if you're buying in to what the AMA is saying, you are a goddamn fool," says Myers. "The lines are drawn."

See also:

• Polio gets a reboot
• Flu hits young adults hard
• Wiping out polio: How the U.S. snuffed out a killer